RESUMO
Introducción: En el contexto de una sociedad global y diversa, los cuidados de enfermería con congruencia cultural son una necesidad apremiante. Los acelerados procesos migratorios, los cambios en la economía global y el reconocimiento universal de los derechos humanos son evidencias inequívocas de esta necesidad. Objetivo: Identificar las evidencias sobre los beneficios del cuidado de enfermería con congruencia cultural, en el bienestar y satisfacción del paciente. Métodos: Revisión sistemática integrativa de estudios originales publicados del 2000-2019, en español e inglés. Se utilizaron siete bases de datos: SciELO, Lilacs, EBSCO Host, Dialnet, DOAJ, Redalyc y Pubmed, con la estrategia de búsqueda: "cuidado cultural" AND "enfermería", "cultural congruent care" AND "nursing" OR "cultural care" AND "nursing", cuidado cultural. Se seleccionaron 14 artículos a los que se realizó análisis de contenido. Conclusiones: Los artículos seleccionados permitieron identificar los beneficios de los cuidados de enfermería con congruencia cultural observados en diferentes grupos como adultos, adultos mayores y sus cuidadores, madres lactantes, escolares y adolescentes. Los beneficios del cuidado cultural se evidenciaron al abordar fenómenos como la funcionalidad familiar, la sobrecarga del cuidador, la promoción de la lactancia materna, el manejo del estrés, la ansiedad, la depresión y la calidad de vida de las sobrevivientes de cáncer de mama. Los cuidados de enfermería con congruencia cultural evidenciaron el desarrollo de una mejor relación enfermera-paciente y una mayor satisfacción de los pacientes y sus familias(AU)
Introduction: In the context of a global and diverse society, culturally congruent nursing care is an urgent need. Accelerated migration processes, changes in the global economy and universal recognition of human rights unequivocally evidence this need. Objective: To identify evidence on the benefits of culturally congruent nursing care as part of patient well-being and satisfaction. Methods: Integrative systematic review of original studies published from 2000 to 2019 in Spanish and English. Seven databases were used: SciELO, Lilacs, EBSCO Host, Dialnet, DOAJ, Redalyc and Pubmed. The following search strategy was designed: "cuidado cultural" AND "enfermería", "cultural congruent care" AND "nursing" OR "cultural care" AND "nursing", cuidado cultural [cultural care]. Fourteen articles were selected and processed through content analysis. Conclusions: The selected articles permitted to identify the benefits of culturally congruent nursing care observed in different groups such as adults, aged adults and their caregivers, breastfeeding mothers, school children and adolescents. The benefits of cultural care were evidenced by addressing phenomenons such as family functionality, caregiver overload, promotion of breastfeeding, coping with stress, anxiety and depression, as well as quality of life in breast cancer survivors. Culturally congruent nursing care evidenced the development of a better nurse-patient relationship, as well as greater patient and family satisfaction(AU)
Assuntos
Humanos , Satisfação do Paciente , Assistência à Saúde Culturalmente Competente/métodos , Relações Enfermeiro-Paciente , Cuidados de Enfermagem/métodos , Literatura de Revisão como Assunto , Bases de Dados BibliográficasRESUMO
Introducción: La actuación de enfermería y el desarrollo de su práctica social están guiadas, de manera general, por los conceptos propuestos por las diferentes teorías y modelos de la profesión y el método científico que mediante una adecuada valoración de las necesidades afectadas contribuye al bienestar físico y psicológico del paciente oncológico. Objetivo: Identificar los referentes teóricos que sustentan la actuación de los profesionales de enfermería en el cuidado a los pacientes con cáncer. Métodos: Se efectuó una sistematización de la literatura científica en repositorios y bases de datos electrónicas en revistas nacionales e internacionales de las bases de datos SciELO, Medline, Dialnet y Scopus, sobre los sustentos teóricos que respaldan la actuación de los profesionales de enfermería en el cuidado de personas con diagnóstico médico de cáncer. Resultados: La revisión realizada permitió documentar la aplicabilidad de las teorías y modelos en el cuidado del paciente oncológico, son la Teoría de los Síntomas Desagradables, el Modelo de Promoción de Salud (MPS), la Teoría del Déficit de Autocuidado y la Teoría de la Transculturación, expuestos en las dimensiones de fatiga, actividad física, autocuidado y cuidados culturales. Conclusiones: La sistematización realizada permitió identificar algunos referentes teóricos que sustentan la actuación del profesional de enfermería en el cuidado al paciente con cáncer. Todo esto ha quedado documentado de forma tal que sirva como modelo a seguir en la asistencia al relacionar los diferentes tratamientos y los cuidados que se brindan con un respaldo científico, que se traduce en una atención de calidad(AU)
Introduction: Nursing performance and the development of nursing as a social practice are guided, in general, by the concepts proposed by the different theories and models of the profession and the scientific method that, through an adequate assessment of the affected, contributes to the physical and psychological well-being of the oncology patient. Objective: To identify the theoretical referents that support the performance of nursing professionals in the care of cancer patients. Methods: A systematization was carried out with the scientific literature from repositories and electronic databases in national and international journals of the SciELO, Medline, Dialnet and Scopus databases, about the theoretical foundations that support the performance of nursing professionals in the care of people with a medical diagnosis of cancer. Results: The review carried out allowed documenting the applicability of theories and models with respect to the care of the oncological patient: the unpleasant symptom theory, the health promotion model, the self-care deficit theory, and the transculturation theory, exposed in the dimensions of fatigue, physical activity, self-care, and cultural care. Conclusions: The systematization carried out allowed the identification of some theoretical referents that support the performance of the nursing professional in the care of the patient with cancer. All this has been documented in such a way that it serves as a model to be followed in the assistance, by relating the different treatments and care provided with scientific support, which translates into quality care(AU)
Assuntos
Humanos , Qualidade da Assistência à Saúde , Assistência à Saúde Culturalmente Competente/métodos , Neoplasias , Cuidados de Enfermagem/métodos , Publicações Periódicas como Assunto , Autocuidado , Exercício FísicoRESUMO
La prevención de la transmisión vertical de VIH es un desafío para todos los países del mundo. Esto se ve complejizado por la construcción permanente de sociedades globales, con grado variable de población migrante internacional. Las políticas, programas y acciones sanitarias para la prevención de transmisión vertical de VIH en gestantes migrantes demandan una perspectiva intercultural, en donde se aborden todas las dimensiones sociales, culturales y de género asociadas a la infección. El entender la realidad local en cuanto a la prevención de transmisión vertical de VIH en población migrante internacional en Chile es esencial para llevar acciones concretas que favorezcan la prevención de transmisión madre-hijo de VIH. En este artículo se presentan algunos conceptos esenciales relacionados a esta temática. También se expone información internacional y nacional sobre riesgos de transmisión vertical de VIH en migrantes gestantes, la importancia del plan nacional de preven ción de transmisión vertical de VIH en nuestro país, y algunos esfuerzos que se están realizando para adaptar dicho plan a la realidad de diversidad social y cultural que migrantes gestantes presentan hoy en Chile, como un valioso insumo de salud pública con perspectiva intercultural.
Preventing vertical transmission of HIV is a challenge for all countries worldwide. The permanent construction of global societies with a variable degree of international migrant population has made it more complex. Health policies, programs, and actions for preventing vertical transmission of HIV in pregnant migrants demand an intercultural perspective, where social, cultural, and gender dimen sions associated with the infection are addressed. Understanding the local reality regarding the pre vention of vertical transmission in the international migrant population in Chile is essential to carry out concrete actions that favor the prevention of mother-to-child transmission of HIV. This article presents some essential concepts related to this topic. It also presents international and national in formation on risks of vertical transmission in pregnant migrants, the importance of the national plan for preventing vertical transmission of HIV in our country, and some ongoing efforts to adapt such plan to the reality of social and cultural diversity that pregnant migrants currently present in Chile, as a useful public health instrument with an intercultural perspective.
Assuntos
Humanos , Feminino , Gravidez , Recém-Nascido , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/etnologia , Complicações Infecciosas na Gravidez/terapia , Cuidado Pré-Natal/métodos , Migrantes , Infecções por HIV/transmissão , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Emigrantes e Imigrantes , Assistência à Saúde Culturalmente Competente/métodos , Infecções por HIV/diagnóstico , Infecções por HIV/etnologia , Infecções por HIV/terapia , Chile/epidemiologia , Determinantes Sociais da Saúde , Política de SaúdeRESUMO
The Ostomy Adjustment Inventory-23 (OAI-23) was developed in English to measure the social and psychological adaptation of individuals who underwent ostomy surgeries. PURPOSE: The aim of the current study was to culturally adapt and test the measurement properties of a Brazilian Portuguese adapted version of the OAI-23. METHODS: The original version of the OAI-23 was composed of 23 questions distributed into the following 4 factors: acceptance, anxiety/preoccupation, social engagement, and anger. The OAI-23 was translated into Portuguese, reviewed by a committee of expert reviewers, pretested on a focus group, and back-translated. Using convenience sampling methods, patients who were treated at specialized health centers located in different parts of Brazil were invited to complete a demographic and health history questionnaire, the Janis and Field Self-Esteem Scale, and the adapted version of OAI-23 to assess its reliability, convergent construct validity, and discriminant construct validity. RESULTS: A total of 191 patients with a mean age of 58.9 years (SD = 14.7) (74.1% with colostomies, 19.6% with ileostomies, and 6.3% with urostomies) participated in the study. The Brazilian Portuguese adapted version of the OAI-23 had a Cronbach's alpha coefficient of 0.846 and an intra-class correlation coefficient of 0.903 (P < .001). Significant correlations between OAI-23 scores and self-esteem scale scores confirmed the convergent construct validity, and the instrument was able to discriminate patients' adjustment according to age. CONCLUSION: The adapted version of the OAI-23 proved to be reliable and valid for use in Brazil; this represents the first instrument capable of assessing psychosocial adaptation of patients with stomas in that country.
Assuntos
Atitude Frente a Saúde , Imagem Corporal/psicologia , Estomia/psicologia , Idoso , Brasil , Assistência à Saúde Culturalmente Competente/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estomia/métodos , Psicometria/instrumentação , Psicometria/métodos , Qualidade de Vida/psicologia , Reprodutibilidade dos Testes , Inquéritos e Questionários , TraduçãoRESUMO
Culturally adapted evidence-based parenting interventions constitute a key strategy to reduce widespread mental health disparities experienced by Latinx populations throughout the United States. Most recently, the relevance of culturally adapted parenting interventions has become more prominent as vulnerable Latinx populations are exposed to considerable contextual stressors resulting from an increasingly anti-immigration climate in the country. The current study was embedded within a larger NIMH-funded investigation, aimed at contrasting the differential impact of two culturally adapted versions of the evidence-based parenting intervention known as GenerationPMTO©. Specifically, a sample of low-income Mexican-origin immigrants was exposed either to a culturally adapted version of GenerationPMTO primarily focused on parent training components, or to an enhanced culturally adapted version in which parenting components were complemented by sessions focused on immigration-related challenges. The sample for the study consisted of 103 Mexican-origin immigrant families (190 individual parents). Descriptive analysis and generalized estimating equations (GEEs) indicated that exposure to the enhanced intervention, which included context- and culture-specific sessions, resulted in specific benefits for parents. However, the magnitude of the impact was not uniform for mothers and fathers and differed according to the type of immigration-related stress being examined (i.e., intrafamilial vs. extrafamilial stress). Overall, findings indicate the relevance of overtly addressing contextual (e.g., discrimination) and cultural challenges in culturally adapted interventions, as well as the need to increase precision according to the extent to which immigration-related stressors impact immigrant mothers and fathers in common and contrasting ways. Implications for family therapy practice and research are discussed.
Las intervenciones basadas en evidencia, dirigidas a padres y adaptadas a la cultura son una estrategia clave para reducir las desigualdades en salud mental generalizadas que las poblaciones de latin@s experimentan en los Estados Unidos. Más recientemente, la relevancia de intervenciones dirigidas a padres adaptadas a la cultura ha adquirido más peso al estar las poblaciones de latin@s expuestas a factores estresantes contextuales considerables como resultado de un ambiente cada vez más contrario a la inmigración en el país. Este estudio fue incluido dentro de una investigación de mayor escala financiada por NIMH cuyo objetivo era contrastar el impacto diferencial de dos versiones adaptadas a la cultura de la intervención basada en evidencia y dirigida a padres conocida como GenerationPMTO© . En específico, se expuso una muestra de inmigrantes de origen mexicano de bajo ingreso, o a una versión de GenerationPMTO adaptada a la cultura y enfocada principalmente en elementos de entrenamiento de padres, o a una versión reforzada adaptada a la cultura en la cual los elementos de padres se complementaron con sesiones enfocadas en retos asociados a la inmigración. La muestra para el estudio consistió de 103 familias inmigrantes de origen mexicano (190 padres individuales). Análisis descriptivos y ecuaciones de estimación generalizadas indicaron que la exposición una intervención reforzada, que incluía sesiones contextual y culturalmente específicas, generaron beneficios específicos para los padres. Sin embargo, la magnitud del impacto no fue uniforme para madres y padres y fue distinta según el tipo de estrés por inmigración examinado (p.ej., estrés intrafamiliar versus estrés extrafamiliar). En general, los hallazgos indican la relevancia de enfrentar abiertamente retos contextuales (p.ej., discriminación) y culturales en intervenciones adaptadas a la cultura, así como la necesidad de aumentar la precisión conforme a cómo los factores estresantes asociados a la inmigración afectan a madres y padres inmigrantes de la misma y diferentes maneras. Se discuten las implicaciones para la práctica e investigación de terapia familiar.
Assuntos
Assistência à Saúde Culturalmente Competente/métodos , Educação não Profissionalizante/métodos , Terapia Familiar/métodos , Americanos Mexicanos/psicologia , Estresse Psicológico/terapia , Adulto , Criança , Transtornos do Comportamento Infantil/etnologia , Transtornos do Comportamento Infantil/terapia , Pré-Escolar , Emigrantes e Imigrantes/psicologia , Feminino , Humanos , Masculino , México/etnologia , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Pobreza/etnologia , Pobreza/psicologia , Estresse Psicológico/etnologia , Estresse Psicológico/psicologia , Estados Unidos , Populações Vulneráveis/etnologia , Populações Vulneráveis/psicologiaRESUMO
Preventing vertical transmission of HIV is a challenge for all countries worldwide. The permanent construction of global societies with a variable degree of international migrant population has made it more complex. Health policies, programs, and actions for preventing vertical transmission of HIV in pregnant migrants demand an intercultural perspective, where social, cultural, and gender dimen sions associated with the infection are addressed. Understanding the local reality regarding the pre vention of vertical transmission in the international migrant population in Chile is essential to carry out concrete actions that favor the prevention of mother-to-child transmission of HIV. This article presents some essential concepts related to this topic. It also presents international and national in formation on risks of vertical transmission in pregnant migrants, the importance of the national plan for preventing vertical transmission of HIV in our country, and some ongoing efforts to adapt such plan to the reality of social and cultural diversity that pregnant migrants currently present in Chile, as a useful public health instrument with an intercultural perspective.
Assuntos
Assistência à Saúde Culturalmente Competente/métodos , Emigrantes e Imigrantes , Infecções por HIV/transmissão , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Complicações Infecciosas na Gravidez , Cuidado Pré-Natal/métodos , Migrantes , Chile/epidemiologia , Feminino , Infecções por HIV/diagnóstico , Infecções por HIV/etnologia , Infecções por HIV/terapia , Política de Saúde , Humanos , Recém-Nascido , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/etnologia , Complicações Infecciosas na Gravidez/terapia , Determinantes Sociais da SaúdeRESUMO
Contiene un marco legal sobre la salud de los pueblos indígenas. El objetivo del documento es el de "Propiciar un espacio de encuentro y consenso entre las percepciones y expectativas de terapeutas tradicionales y prestadores de salud institucional, basado en la generación de la auto-identidad y el respeto a las diferencias." Señala además que, "La atención primaria en salud requiere de establecimientos adecuados y personal sensibilizado para prestar sus servicios con pertinencia cultural, la cual, es un enfoque de intervención que busca que la atención sanitaria sea conceptualizada, organizada e implementada tomando como referentes los valores de la cosmovisión de los pueblos indígenas." Enfatizando ser una estrategia institucional, agrega que: "El Departamento de Promoción y Educación en Salud de la DGSIAS propone esta metodología para la realización de diálogos interculturales que tiene como objetivo principal generar un proceso estratégico para la adecuación de los servicios de salud y la sensibilización del personal hacia una atención con pertinencia cultural." Hace referencia al documento: "Normas con pertinencia cultural: hacia la interculturalidad", que también puede encontrarse en eBlueInfo En el marco conceptual, aborda términos relacionados, y específicamente enumera los nombres (en lengua) y sus "especialidades" en la medicina tradicional. "Esta metodología fue construida con acompañamiento de la Unidad de Atención en Salud para Pueblos Indígenas e Interculturalidad (UASPIIG) y validada en campo entre los años 2014 y 2015 como ejercicio de diálogos entre comadronas y proveedores de servicios de salud del MSPAS, en la plataforma de intervención del Proyecto Mesoamérica 2015." Incluye además, talleres de concientización intercultural, tanto para "terapeutas tradicionales", como para el personal médico.
Assuntos
Humanos , Masculino , Feminino , Etnicidade/legislação & jurisprudência , Competência Cultural/legislação & jurisprudência , Competência Cultural/organização & administração , Assistência à Saúde Culturalmente Competente/métodos , Assistência à Saúde Culturalmente Competente/organização & administração , Política de Saúde/tendências , Pessoal de Saúde/tendências , Cultura , Fatores Culturais , Pessoal Técnico de Saúde/normas , Direitos Culturais , Guatemala , Medicina TradicionalRESUMO
OBJECTIVE: To identify the importance of the cultural care dimension in the nurse-puerperal mother interaction. METHOD: Qualitative study based on content analysis. To collect data, 36 semi structured interviews were applied (21 nurses and 15 women who had recently given birth). The participants' free and informed consent was ensured and all ethical requirements were respected. Data analysis was supported by NVivo 10 software. RESULTS: The following categories were considered the most relevant: (i) nurses' attitudes that puerperal mothers consider crucial in health care provision; (ii) nurses' cultural competence; (iii) language resources used by nurses in their interaction with people from other cultures; (iv) the limitations that were observed during nurses-new mothers interactions. CONCLUSION: Evidence shows that, generally speaking, nurses claim to provide personalized health care assistance. However data revealed that the kind of interaction observed between nurses and women who had just given birth has not always been the most effective and that the former often show they lacked the appropriate cultural competence to deal with the latter's expectations and needs.
Assuntos
Formação de Conceito , Assistência à Saúde Culturalmente Competente/normas , Enfermagem Obstétrica/normas , Adulto , Atitude do Pessoal de Saúde , Assistência à Saúde Culturalmente Competente/métodos , Assistência à Saúde Culturalmente Competente/tendências , Feminino , Humanos , Relações Enfermeiro-Paciente , Enfermagem Obstétrica/tendências , Período Pós-Parto/psicologia , Pesquisa QualitativaRESUMO
ABSTRACT Objective: To identify the importance of the cultural care dimension in the nurse-puerperal mother interaction. Method: Qualitative study based on content analysis. To collect data, 36 semi structured interviews were applied (21 nurses and 15 women who had recently given birth). The participants' free and informed consent was ensured and all ethical requirements were respected. Data analysis was supported by NVivo 10 software. Results: The following categories were considered the most relevant: (i) nurses' attitudes that puerperal mothers consider crucial in health care provision; (ii) nurses' cultural competence; (iii) language resources used by nurses in their interaction with people from other cultures; (iv) the limitations that were observed during nurses-new mothers interactions. Conclusion: Evidence shows that, generally speaking, nurses claim to provide personalized health care assistance. However data revealed that the kind of interaction observed between nurses and women who had just given birth has not always been the most effective and that the former often show they lacked the appropriate cultural competence to deal with the latter's expectations and needs.
RESUMEN Objetivo: identificar la dimensión de la competencia cultural en la interacción entre enfermeras y mujeres que hayan dado a luz recientemente. Método: estudio cualitativo basado en el análisis de contenidos. En la recopilación de datos se utilizó la entrevista semiestructurada. Han participado 21 enfermeras y 15 madres en un total de 36 entrevistas. Se aseguró el consentimiento previo, libre e informado de todos los participantes y todos los requisitos éticos fueron respetados. El análisis de datos fue apoyado por el programa NVivo 10. Resultados: las siguientes categorías fueron destacadas: (i) actitudes de las enfermeras que las madres creen ser indispensables en el proceso de cuidar; ii) el ejercicio de la competencia cultural; iii) los recursos lingüísticos utilizados por las enfermeras en la interacción con personas de otras culturas; iv) restricciones y problemas observados en las interacciones entre enfermeras y madres. Conclusión: se concluye que, en general, las enfermeras afirman que cuidan de sus pacientes de manera personalizada. Todavía, los datos revelaron que las interacciones entre enfermeras y madres son a menudo poco eficaces y a las enfermeras les resulta difícil demostrar su competencia cultural.
RESUMO Objetivo: Identificar a dimensão do cuidado cultural na interação entre enfermeiras e puérperas. Método: Estudo qualitativo assente na análise de conteúdo. Na colheita de dados se utilizou a entrevista semiestruturada, a 21 enfermeiras e 15 puérperas num total de 36 entrevistadas. Se assegurou o consentimento livre e esclarecido bem como respeitaram-se todos os requisitos éticos. A análise de dados foi suportada pelo NVivo 10. Resultados: Destacaram-se as categorias: (i) Atitudes das enfermeiras que as puérperas reconhecem imprescindíveis no processo de cuidar; (ii) Exercitar a competência cultural; (iii) Recursos linguísticos utilizados pelas enfermeiras na interação com pessoas de outras culturas; (iv) Constrangimentos manifestados nas interações enfermeiras e puérperas. Conclusão: Conclui-se que apesar das enfermeiras, ao nível discursivo, afirmarem que cuidam de forma personalizada, os dados revelaram que nem sempre as enfermeiras foram eficazes nas interações com as puérperas, de forma a demonstrarem a competência cultural, num estadio considerado culturalmente consciente.
Assuntos
Humanos , Feminino , Adulto , Formação de Conceito , Assistência à Saúde Culturalmente Competente/normas , Enfermagem Obstétrica/normas , Atitude do Pessoal de Saúde , Pesquisa Qualitativa , Período Pós-Parto/psicologia , Assistência à Saúde Culturalmente Competente/métodos , Assistência à Saúde Culturalmente Competente/tendências , Relações Enfermeiro-Paciente , Enfermagem Obstétrica/tendênciasRESUMO
CONTEXT: A key component of the improvement of public health infrastructure in the United States revolves around public health workforce development and training. Workforce challenges faced by the public health system have long been recognized, but there are additional challenges facing any region-wide or cross-jurisdictional effort to accurately assess priority workforce training needs and develop training resources to address those needs. These challenges include structural variability of public health organizations; diverse population health contexts; capturing both topic-specific skill sets and foundational competencies among public health workers; and reaching/representing the target population despite suspicion, disinterest, and/or assessment "fatigue" among employees asked to participate in workforce development surveys. OBJECTIVE: The purpose of this article is to describe the challenges, strategies to meet those challenges, and lessons learned conducting public health workforce training needs assessments by academic and practice partners of the Region 2 Public Health Training Center (R2/PHTC). SETTING AND PARTICIPANTS: The R2/PHTC is hosted by the Mailman School of Public Health at Columbia University and serves New York, New Jersey, Puerto Rico, and the US Virgin Islands within its jurisdiction. RESULTS: Strategies for responding to diverse organizational structures and population health contexts across the region; defining training priorities that address both foundational competencies for public health professionals and content-specific training to address local public health needs; reaching/representing target populations of public health workers; and analysis and report writing to encourage rapid response to identified needs and comprehensive workforce development planning are discussed. Lessons learned are likely instructive to other workforce training needs assessments in complex and ever-changing public health environments.